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Background: Postoperative pain management remains a major challenge after laparoscopic procedures. Effective pain control encourages early ambulation, which significantly reduces the risk of deep vein thrombosis and to decrease the other risk of complications. Aims & Objectives: The present study is designed to evaluate the effect of intraperitoneal instillation with 0.5% ropivacaine as pre insufflation and at the time of closure in patients undergoing laparoscopic cholecystectomy. Materials and Methods: In this observational study, seventy patients belonging to ASA I and ASA II aged between 18 to 65 years were randomly allocated to two groups Group A (n=35) and Group B (n=35), undergoing laparoscopic cholecystectomy. Patients belonging to group A received 2 mg/kg of 0.5% ropivacaine before insufflation of gas and patients belonging to Group B received the same as wound infiltration at the time of closure. Injection diclofenac sodium intravenous was given as a rescue analgesia when required. We observed pain intensity with Visual Analogue Scale VAS score at 0.5, 1, 2, 4, 6, 12, 24 h after surgery and over all VAS score (mean of all VAS scores), time for first analgesic requirement, total diclofenac sodium consumption and incidence of nausea and vomiting. Results: Mean VAS score immediately after the surgery for group A was (2.5±1.2) significantly lower than group B (5.2±2.9, P=0.0001). First analgesic dose requirement time was longer in group A (6.25 hours) than group B(4.50 hours ,P=0.0003). Total amount of diclofenac sodium required in group A(75±4.3mg) was less than group B(160±5.9mg,P=0.054) Incidence of post operative complications were equal in both the groups. Conclusion: Infiltration with 0.5% Ropivacaine significantly decreases post-operative pain intensity and diclofenac sodium consumption in patients undergoing laparoscopic cholecystectomy. Infiltration has better effect when given pre insufflation.

journal of medical science and clinical research

To evaluate the effect of intraperitoneal instillation with 0.5% ropivacaine as pre insufflation and at the time of closure in patients undergoing laparoscopic cholecystectomy